Effect of Liquid Bolus Consistency and Delivery Method on Aspiration and Pharyngeal Retention in Dysphagia Patients

There is no empirically derived consensus as to what food consistency types and method of food delivery (spoon, cup, straw) should be included in the videofluoroscopic swallowing (VFSS) studies. In the present study, we examine the rates of aspiration and pharyngeal retention in 190 dysphagic patients given thin (apple juice) and thick (apricot nectar) liquids delivered by teaspoon and cup and ultrathick (pudding-like) liquid delivered by teaspoon. Each patient was tested with each of the bolus/delivery method combinations. The fractions of patients exhibiting aspiration for each bolus/method of delivery combination were (1) thick liquids (cup), 13.2%; (2) thick liquids (spoon), 8.9%; (3) thin liquids (cup), 23.7%; (4) thin liquids (spoon), 15.8%, (5) ultrathick liquids (spoon), 5.8%. In each comparison [thick liquid (cup) vs. thick liquid (spoon), thin liquid (cup) vs. thin liquid (spoon), thick liquid (cup) vs. thin liquid (cup), thick liquid (spoon) vs. thin liquid (spoon), and thick liquid (spoon) vs. ultrathick liquid (spoon)], the p value for χ² was <0.001. These results suggest that utilizing thin, thick, and ultrathick liquids and delivery by cup and spoon during a VFSS of a patient with mild or moderate dysphagia can increase the chances of identifying a consistency that the patient can swallow without aspirating and without pharyngeal retention after swallowing. Submitted December 22, 1999; accepted September 6, 2000 with revision     

Creation of a High‐fidelity,Low‐cost Pediatric Skull Fracture Ultrasound Phantom

Over the past decade, point‐of‐care ultrasound has become a common tool used for both procedures and diagnosis. Developing high‐fidelity phantoms is critical for training in new and novel point‐of‐care ultrasound applications. Detecting skull fractures on ultrasound imaging in the younger‐than‐2‐year‐old patient is an emerging area of point‐of‐care ultrasound research. Identifying a skull fracture on ultrasound imaging in this age group requires knowledge of the appearance and location of sutures to distinguish them from fractures. There are currently no commercially available pediatric skull fracture models. We outline a novel approach to building a cost‐effective, simple, high‐fidelity pediatric skull fracture phantom to meet a unique training requirement.     

Use of three‐dimensional power doppler sonography in the diagnosis of uterine arteriovenous malformation and follow‐up after uterine artery embolization: Case report and brief review of literature

Arteriovenous malformations (AVM) of the uterus can cause life‐threatening hemorrhage. Unexplained, heavy vaginal bleeding in a reproductive age woman should raise suspicion for an AVM. Here a 37‐year‐old woman had increasingly severe vaginal bleeding for 15 days. Serum β‐hCG was elevated. Two‐dimensional transvaginal ultrasound suggested retained products of conception. Before dilation and curettage (D&C), color Doppler and three‐dimensional (3D) power Doppler demonstrated findings indicative of uterine AVM. A bilateral uterine artery embolization was performed without complications. Three months after uterine artery embolization, 3D power Doppler ultrasonography found complete resolution of the AVM. This case illustrates the importance of assessing both gray‐scale and 3D power Doppler, and the ability of postprocedure Doppler to assess resolution. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43:327–334, 2015     

2018年勐腊县城区登革热暴发流行特征与媒介应急监测分析

目的分析2018年勐腊县城区登革热暴发时的流行病学特征、媒介生物学特性等变化情况,为登革热的防控提供依据。方法对勐腊城区疑似登革热病例进行流行病学调查,并开展登革病毒NS1抗原快速检测,首例病例用RT-PCR进行登革病毒核酸检测及型别鉴定;采用背负式吸蚊器法和布雷图指数法分别开展媒介伊蚊成蚊和幼虫的监测;采用三间分布法对疫情特征进行描述,计算成蚊密度和幼虫密度,采用χ^2检验对不同类型孳生阳性率进行比较分析。结果本次疫情共发现病例59例,罹患率为161.38/10万,流行历时77 d。8月份为发病高峰,患者男女比为0.68∶1,以青壮年为主,从事职业以商业服务、离退休和家中待业居多;捕获埃及伊蚊和白纹伊蚊成蚊1 340只,其中埃及伊蚊占80.15%。幼虫监测,13 148户,阳性784户,积水容器13 387个,阳性1 067个,总BI为8.12、总HI为5.96、总CI为7.97%。积水容器类型构成以水桶为主,其次为花瓶。水缸、花瓶、废旧轮胎、竹筒、菜坛、水桶、废弃瓶/罐、其他暂时性容器的伊蚊幼蚊阳性率分别为7.17%、6.07%、24.79%、15.15%、10.12%、6.51%、16.62%、和6.42%。结论 2018年勐腊城区登革热暴发流行的特征与既往比较无明显变化。埃及伊蚊和白纹伊蚊在城区均有分布,以埃及伊蚊为优势蚊种,其种群密度进一步扩大。废旧轮胎、竹筒和水桶等常见伊蚊幼虫孶生地,应及时清除,并开展居民区室内外灭蚊清除工作,同时加大宣传,提高居民的自我防护和家庭防护能力,提升居民参与防控的积极性,以达到群防群控。